Investigation of the social context and physical environment on cardiovascular disease disparities in the All of Us Research Program

“我们所有人研究计划”中心血管疾病差异的社会背景和物理环境调查

• 批准号: 10798725
• 负责人: Briseis A Aschebrook-Kilfoy
• 金额: $ 16.4万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-10 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10798725
• 关键词: Address; Air Pollution; All of Us Research Program; American; Animals; Area; Asthma; Behavior; Biomedical Research; Cardiovascular Diseases; Categories; Characteristics; Chicago; Chronic Disease; Communities; Community Surveys; Complex; Data; Data Set; Disease Outcome; Disparity; Environmental Hazards; Environmental Impact; Environmental Risk Factor; Factor Analysis; GSTM1 gene; GSTP1 gene; GSTT1 gene; Genes; Health; Illinois; Impairment; Individual; Investigation; Joints; Knowledge; Link; Literature; Low income; Measurement; Methods; Mission; Modeling; Modification; Morbidity - disease rate; Neighborhoods; Participant; Persons; Physical environment; Population; Population Heterogeneity; Prevalence; Publishing; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Science; Site; Social Environment; Sum; Training; United States National Aeronautics and Space Administration; Universities; Weight; Work; analytical method; cardiovascular disorder risk; cardiovascular health; cohort; coping; demographics; deprivation; disease disparity; disorder risk; environmental justice; ethnic disparity; fine particles; health disparity; insight; interest; minority communities; mortality; neighborhood association; novel; novel strategies; precision medicine; protective factors; racial disparity; social determinants; social influence; stroke risk; training opportunity; working group

Abstract Persistent prevalence of cardiovascular disease (CVD) and its high morbidity and mortality suggest that there are significant gaps in our understanding of the mechanisms that impair CVD health and better strategies are needed. It is well known in the scientific community that the impact of environmental justice on CVD extends beyond that of air pollution and encompasses neighborhood deprivation and social determinants. The literature also consistently demonstrates that low income, vulnerable, and underrepresented individuals are at the greatest risk of excessive exposure and lower resources to cope with and respond to the problems posed by these factors, including CVD. However, integrated, and comprehensive investigation of the multiple layers of environmental influence with individual-level factors is limited, especially in studies powered to investigate racial/ethnic disparities. We recently estimated that median All of Us participant PM2.5 level is 10 μg/m3, slightly higher than the US average of 7 μg/m3 and that people in the highest category have a 1.5 times increased risk of stroke. These preliminary results suggest that effects are certainly being detected, but the story is complex and requires analytic methods to tease apart correlated effects, weight influence, consider the effect of bias and offer insight into the factors commonly thought to be protective among diverse populations and communities. This project leverages the unprecedented opportunity to utilize existing data in the All of Us Researcher Workbench, our prior linkage of environmental factors into the dataset, and novel analytic methods to investigate how the social context and physical environment jointly contributes to disparities in CVD risk, and to further evaluate the impact of individual-level factors (e.g., established genes, individual demographics) on the modification and/or mitigation of these impacts. Our prior work in this area highlights how novel methods such as weighted quantile sum regression can offer interpretable effects and clear messaging on the percent contribution of different factors to chronic disease risk and disparities. As such, in addition to leveraging the unprecedented diversity in this national cohort, the approach is responsive to what our IPMC communities and community partners have requested in terms of areas of research interest and understandable answers.

抽象的 心血管疾病（CVD）的持续流行及其高发病率和死亡率表明， 我们对损害 CVD 健康的机制的理解存在重大差距，更好的策略是 科学界众所周知，环境正义对心血管疾病的影响是广泛的。 除了空气污染之外，还包括邻里贫困和社会决定因素。 也始终表明，低收入、弱势群体和代表性不足的个人面临着最大的困难 过度暴露的风险和较少的资源来应对和应对这些因素造成的问题， 然而，对环境的多个层面进行综合、全面的调查。 个人层面因素的影响是有限的，特别是在旨在调查种族/民族的研究中 我们最近估计，我们所有参与者的 PM2.5 水平中位数为 10 μg/m3，略高于 美国平均水平为 7 μg/m3，处于最高类别的人罹患此病的风险增加了 1.5 倍 这些初步结果表明，确实已经检测到了中风的影响，但情况很复杂，而且也很复杂。 需要分析方法来梳理相关效应、权重影响、考虑偏差的影响并提供 深入了解不同人群和社区中普遍认为具有保护作用的因素。 项目利用前所未有的机会利用我们所有人研究人员工作台中的现有数据， 我们之前将环境因素与数据集联系起来，以及研究如何利用新的分析方法 社会背景和自然环境共同导致CVD风险的差异，并进一步评估 个体层面因素（例如，既定基因、个体人口统计数据）对修改和/或 我们之前在该领域的工作强调了加权分位数等新颖方法的作用。 总和回归可以提供可解释的效果，并就不同因素的贡献百分比提供清晰的信息 因此，除了利用这方面前所未有的多样性之外。 全国队列，该方法响应我们的 IPMC 社区和社区合作伙伴的情况 根据研究兴趣领域和可理解的答案提出要求。